Wiki E&M denial off inpatient status

[atoonkel@communitycare.com]

Hello,

We have a patient that was seen in the office as a follow up to inpatient services. A couple of days later the patient ended up back in the hospital. Medicare has the patient listed as inpatient for our date of service and is denying the claim. We are billing a E&M 99214.

The Hospital confirmed the patient was not in the hospital for our dos. They are stating we are billing this incorrectly.

Any suggestion on where to research this?

best,
Amy

 

[trarut]

Was your claim processed with the incorrect POS code by Medicare? If it's not a POS error on your claim, I would either ask the hospital to investigate and report a discharge date or correct the discharge date with Medicare OR try to submit hospital records showing the discharge prior to your date of service.

 

[atoonkel@communitycare.com]

Our place of service was 11 for the office. It was the same as always. Thank you for the advise. I will mention these things when the billing rep at the hospital calls back.

 

[trarut]

Welcome! Hope you get a resolution.